﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-01T11:15:31-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>620788068</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PURYEAR &amp; NOONAN CPAS</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>40 BURTON HILLS BLVD STE 170</AddressLine1Txt>
        <CityNm>NASHVILLE</CityNm>
        <StateAbbreviationCd>TN</StateAbbreviationCd>
        <ZIPCd>37215</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>203037016</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>TENNESSEE RURAL HEALTH RECRUITMENT &amp;</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>RETENTION CENTER INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>TENN</BusinessNameControlTxt>
      <PhoneNum>6152427872</PhoneNum>
      <USAddress>
        <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
        <CityNm>BRENTWOOD</CityNm>
        <StateAbbreviationCd>TN</StateAbbreviationCd>
        <ZIPCd>37027</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>PAUL BOLIN</PersonNm>
      <PersonTitleTxt>TREASURER</PersonTitleTxt>
      <PhoneNum>6152427872</PhoneNum>
      <SignatureDt>2024-10-31</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>MICHELLE BRAMEL CPA</PreparerPersonNm>
      <PTIN>P00254619</PTIN>
      <PhoneNum>6152960500</PhoneNum>
      <PreparationDt>2024-10-31</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>TENNESSEE CENTER FOR HEALTH WORKFORCE DEVELOPMENT</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>SCOTT TONGATE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
        <CityNm>BRENTWOOD</CityNm>
        <StateAbbreviationCd>TN</StateAbbreviationCd>
        <ZIPCd>37027</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>9275753</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.TNCWD.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2005</FormationYr>
      <LegalDomicileStateCd>TN</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE MISSION OF THE ORGANIZATION IS TO ENHANCE STATEWIDE COLLABORATION ON WORKFORCE PLANNING TO BETTER SERVE RURAL AND UNDERSERVED COMMUNITIES AND HEALTH PROVIDERS IN TENNESSEE BY ASSISTING IN THE RECRUITMENT, PLACEMENT AND RETENTION OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>22</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>22</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>7297741</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>7771469</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>0</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>177438</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>80693</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>12746</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>7487925</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>7852162</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>6444250</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>6927264</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>371276</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>455698</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>494730</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>395856</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>7310256</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>7778818</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>177669</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>73344</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>7586966</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>10480236</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>6598049</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>8379530</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>988917</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>2100706</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>THE MISSION OF THE ORGANIZATION IS TO ENHANCE STATEWIDE COLLABORATION ON WORKFORCE PLANNING TO BETTER SERVE RURAL AND UNDERSERVED COMMUNITIES AND HEALTH PROVIDERS IN TENNESSEE BY ASSISTING IN THE RECRUITMENT, PLACEMENT AND RETENTION OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>7778818</ExpenseAmt>
      <GrantAmt>6927264</GrantAmt>
      <Desc>THE ORGANIZATION STRIVES TO ENHANCE THE PROVISION OF QUALITY HEALTH CARE IN RURAL AND UNDERSERVED COMMUNITIES IN TENNESSEE ONE RELATIONSHIP AT A TIME BY INCREASING ACCESS TO HEALTHCARE FOR RURAL AND UNDERSERVED CITIZENS IN TENNESSEE, BY INCREASING THE SUPPLY OF HEALTH PROFESSIONALS IN RURAL AND UNDERSERVED AREAS IN TENNESSEE, BY ASSISTING RURAL AND UNDERSERVED COMMUNITIES IN DEFINING SPECIFIC HEALTHCARE PROVIDER NEEDS, BY IDENTIFYING STRATEGIES TO ADDRESS THOSE NEEDS, AND BY OFFERING A COST ALTERNATIVE TO BETTER MATCH COMMUNITIES EXPERIENCING DEMAND WITH APPROPRIATE HEALTH CARE PROVIDERS.</Desc>
      <TotalProgramServiceExpensesAmt>7778818</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>143</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>0</Form8899Filedind>
      <Form1098CFiledInd>0</Form1098CFiledInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>22</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>22</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>PAUL BOLIN</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6154017420</PhoneNum>
        <USAddress>
          <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
          <CityNm>BRENTWOOD</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37027</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHAVETTA CONNER MD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN BALDWIN</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARTHA JO EDWARDS EDD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON HAYNES</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SKIPPER BONDURANT</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID MANESS DO</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE BOYNTON</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY LIKES PHD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW BURNETT</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVE CHANEY</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TINA PILGREEN</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTI GRANSTAFF</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAE FLEMING EDD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMANDA STOLTZ</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KYLA TERHUNE MD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROLAND JONES</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACY WARRELL</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RHONDA SWITZER-NADASDI DMD</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VANESSA PATRICK</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT MCGINLEY</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOTHANY REED</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA SMITHGALL</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN TUCKER</PersonNm>
        <TitleTxt>BOARD OF DIRECTORS</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID NEIGER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>221137</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>54986</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT TONGATE</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY WATSON</PersonNm>
        <TitleTxt>WORKFORCE NETWORK DEV DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>100704</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11035</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>321841</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>66021</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>7771469</GovernmentGrantsAmt>
      <TotalContributionsAmt>7771469</TotalContributionsAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>225219</TotalRevenueColumnAmt>
        <ExclusionAmt>225219</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1279065</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1423591</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-144526</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-144526</TotalRevenueColumnAmt>
        <ExclusionAmt>-144526</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7852162</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>80693</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>3636014</TotalAmt>
        <ProgramServicesAmt>3636014</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>3291250</TotalAmt>
        <ProgramServicesAmt>3291250</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>171810</TotalAmt>
        <ProgramServicesAmt>171810</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>238950</TotalAmt>
        <ProgramServicesAmt>238950</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>20251</TotalAmt>
        <ProgramServicesAmt>20251</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>24687</TotalAmt>
        <ProgramServicesAmt>24687</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>27157</TotalAmt>
        <ProgramServicesAmt>27157</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>42795</TotalAmt>
        <ProgramServicesAmt>42795</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OccupancyGrp>
        <TotalAmt>40884</TotalAmt>
        <ProgramServicesAmt>40884</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>22907</TotalAmt>
        <ProgramServicesAmt>22907</ProgramServicesAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>251</TotalAmt>
        <ProgramServicesAmt>251</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>59351</TotalAmt>
        <ProgramServicesAmt>59351</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>ADMINISTRATIVE EXPENSES</Desc>
        <TotalAmt>75000</TotalAmt>
        <ProgramServicesAmt>75000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MED. SCHOOL/GME FEES</Desc>
        <TotalAmt>49160</TotalAmt>
        <ProgramServicesAmt>49160</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>GIFTS/AWARDS</Desc>
        <TotalAmt>45346</TotalAmt>
        <ProgramServicesAmt>45346</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEALS AND ENTERTAINMENT</Desc>
        <TotalAmt>14949</TotalAmt>
        <ProgramServicesAmt>14949</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>18056</TotalAmt>
        <ProgramServicesAmt>18056</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7778818</TotalAmt>
        <ProgramServicesAmt>7778818</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>788463</BOYAmt>
        <EOYAmt>1091542</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>86993</BOYAmt>
        <EOYAmt>119800</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>14841</BOYAmt>
        <EOYAmt>7493</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>17921</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>17376</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>796</BOYAmt>
        <EOYAmt>545</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>6695873</BOYAmt>
        <EOYAmt>9260856</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>7586966</BOYAmt>
        <EOYAmt>10480236</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>149303</BOYAmt>
        <EOYAmt>122993</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>6448746</BOYAmt>
        <EOYAmt>8256537</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>6598049</BOYAmt>
        <EOYAmt>8379530</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>988917</BOYAmt>
        <EOYAmt>2100706</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>988917</BOYAmt>
        <EOYAmt>2100706</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>7586966</BOYAmt>
        <EOYAmt>10480236</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>73344</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1038445</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolAndSepBasisFinclStmtInd>X</ConsolAndSepBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>2551103</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3490274</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9060917</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7297741</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7771469</CurrentTaxYearAmt>
        <TotalAmt>30171504</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus4YearsAmt>976</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3594</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12263</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12746</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>29579</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>2552079</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3493868</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9073180</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7310487</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7771469</CurrentTaxYearAmt>
        <TotalAmt>30201083</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>30201083</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>101906</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>39697</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>78292</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>162262</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>225219</CurrentTaxYearAmt>
        <TotalAmt>607376</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>101906</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>39697</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>78292</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>162262</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>225219</CurrentTaxYearAmt>
        <TotalAmt>607376</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>2653985</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3533565</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9151472</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7472749</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7996688</CurrentTaxYearAmt>
        <TotalAmt>30808459</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98030</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98210</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01970</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01790</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>17921</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>17376</DepreciationAmt>
        <BookValueAmt>545</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>545</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>8834098</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1038445</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>1038445</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>7795653</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>56509</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>56509</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>7852162</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>7722309</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>7722309</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>56509</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>56509</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>7778818</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION RECOGNIZES THE TAX BENEFITS OF UNCERTAIN TAX POSITIONS ONLY WHERE THE POSITION IS "MORE LIKELY THAN NOT" TO BE SUSTAINED ASSUMING EXAMINATION BY TAX AUTHORITIES. MANAGEMENT HAS ANALYZED THE ASSOCIATION'S TAX POSITIONS AND HAS CONCLUDED THAT NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS SHOULD BE RECORDED RELATED TO UNCERTAIN TAX POSITIONS TAKEN ON RETURNS FILED FOR THE OPEN TAX YEARS (2020-2022), OR EXPECTED TO BE TAKEN IN THE ASSOCIATION'S 2023 TAX RETURNS. THE ASSOCIATION IDENTIFIES ITS MAJOR TAX JURISDICTIONS AS THE U.S. FEDERAL AND THE STATE OF TENNESSEE. HOWEVER, THE ASSOCIATION IS NOT CURRENTLY UNDER AUDIT NOR HAS THE ASSOCIATION BEEN CONTACTED BY ANY OF THESE JURISDICTIONS. THE ASSOCIATION IS NOT AWARE OF ANY TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. DURING THE YEARS ENDED DECEMBER 31, 2023 AND 2022, THE ASSOCIATION DID NOT RECOGNIZE ANY INTEREST AND PENALTIES RELATING TO A TAX POSITION, NOR WERE ANY ACCRUED AT DECEMBER 31, 2023 AND 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER NET LOSS INCLUDED AS EXPENSE ON TAX RETURN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER NET LOSS INCLUDED IN INCOME ON AUDITED FINANCIALS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>INCOME ITEMS WITH A DEBIT BALANCE ARE INCLUDED AS EXPENSES ON THE TAX RETURN, WHILE THE AUDITED FINANCIALS HAVE INCLUDED THEM IN THE TOTAL INCOME FIGURE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>INCOME ITEMS WITH A DEBIT BALANCE ARE INCLUDED AS EXPENSES ON THE TAX RETURN, WHILE THE AUDITED FINANCIALS HAVE INCLUDED THEM IN THE TOTAL INCOME FIGURE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SWEETWATER HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>304 CHURCH STREET</AddressLine1Txt>
          <CityNm>SWEETWATER</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37874</ZIPCd>
        </USAddress>
        <RecipientEIN>620544855</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>150000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>KARIS COMMUNITY HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>254 BROAD ST SW</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37311</ZIPCd>
        </USAddress>
        <RecipientEIN>472204923</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>RUTHERFORD COUNTY PRIMARY CARE CLINIC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1453 HOPE WAY</AddressLine1Txt>
          <CityNm>MURFREESBORO</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37129</ZIPCd>
        </USAddress>
        <RecipientEIN>621482091</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF TENNESSEE - HEALTH SCIENCE CENTER GRADUATE MEDICAL EDUCATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>920 MADISON AVE</AddressLine1Txt>
          <CityNm>MEMPHIS</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>38163</ZIPCd>
        </USAddress>
        <RecipientEIN>626001636</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>1510696</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ETSU COLLEGE OF NURSING</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>365 STOUT DRIVE PO BOX 70617</AddressLine1Txt>
          <CityNm>JOHNSON CITY</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37614</ZIPCd>
        </USAddress>
        <RecipientEIN>626021046</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>354026</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MEHARRY MEDICAL COLLEGE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1005 DR DB TODD JR BLVD</AddressLine1Txt>
          <CityNm>NASHVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37208</ZIPCd>
        </USAddress>
        <RecipientEIN>620488046</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>172910</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VANDERBILT UNIVERSITY MEDICAL CENTER - GRADUATE MEDICAL EDUCATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1211 MEDICAL CENTER DRIVE</AddressLine1Txt>
          <CityNm>NASHVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37232</ZIPCd>
        </USAddress>
        <RecipientEIN>352528741</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>984392</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MERCY COMMUNITY HEALTHCARE INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>143 SOUTHEAST PKWY CT</AddressLine1Txt>
          <CityNm>FRANKLIN</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37064</ZIPCd>
        </USAddress>
        <RecipientEIN>621781969</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>47366</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HEALING HANDS HEALTH CENTER INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>245 MIDWAY MEDICAL PARK</AddressLine1Txt>
          <CityNm>BRISTOL</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37620</ZIPCd>
        </USAddress>
        <RecipientEIN>621677000</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>RIDGEVIEW PSYCHIATRIC HOSPITAL &amp; CENTER INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>240 WEST TYRONE ROAD</AddressLine1Txt>
          <CityNm>OAK RIDGE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37830</ZIPCd>
        </USAddress>
        <RecipientEIN>620579512</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>COMMUNITY CLINIC OF SHELBYVILLE &amp; BEDFORD COUNTY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 DOVER ST SUITE 202</AddressLine1Txt>
          <CityNm>SHELBYVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37160</ZIPCd>
        </USAddress>
        <RecipientEIN>341974609</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HOPE FAMILY HEALTH SERVICES</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>SUMNER NORTH HEALTH CENTER 1124 NEW</AddressLine1Txt>
          <AddressLine2Txt>HWY 52 E</AddressLine2Txt>
          <CityNm>WESTMORELAND</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37186</ZIPCd>
        </USAddress>
        <RecipientEIN>201944166</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>32024</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HENRY COUNTY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>301 TYSON AVE</AddressLine1Txt>
          <CityNm>PARIS</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>382424544</ZIPCd>
        </USAddress>
        <RecipientEIN>626007078</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TRINITY HEALTH MINISTRIES INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1127 E LAMAR ALEXANDER PKWY</AddressLine1Txt>
          <CityNm>MARYVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37804</ZIPCd>
        </USAddress>
        <RecipientEIN>203113032</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NEIGHBORHOOD HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2711 FOSTER AVE</AddressLine1Txt>
          <CityNm>NASHVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37210</ZIPCd>
        </USAddress>
        <RecipientEIN>621032792</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>40000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>COMMUNITY INCENTIVE</PurposeOfGrantTxt>
      </RecipientTable>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>RESIDENCY STIPEND SUPPORT</GrantTypeTxt>
        <RecipientCnt>115</RecipientCnt>
        <CashGrantAmt>3291250</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 AND LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THERE IS A STIPEND REVIEW COMMITTEE THAT APPROVES ALL STIPENDS PAID OUT TO THE RECIPIENTS, AND THE APPROVED LIST IS REPORTED TO THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID NEIGER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>159384</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>36041</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>25712</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>26287</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>28699</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>276123</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS FOR TCWD ARE ELECTED BY THE BOARD OF THA, THEIR CONTROLLING ENTITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S PROCESS TO REVIEW FORM 990 PRIOR TO SUBMITTING TCWD'S IRS FORM 990, A COPY OF THE FORM WAS SENT TO EACH BOARD MEMBER. BOARD MEMBERS ARE ENCOURAGED TO CONTACT THE TREASURER WITH ANY QUESTIONS THEY MAY HAVE CONCERNING INFORMATION PRESENTED WITHIN THE FORM AND ATTACHED SCHEDULES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>TENNESSEE RURAL HEALTH RECRUITMENT HAS A VERY COMPREHENSIVE CODE OF BUSINESS CONDUCT THAT ADDRESSES CONFLICT OF INTEREST AND OTHER STANDARDS OF CONDUCT. IT IS TCWD'S POLICY THAT CONFLICTS OF INTEREST BE REPORTED AT ANYTIME A CONFLICT PRESENTS ITSELF, NOT JUST ANNUALLY. "IT IS THE POLICY OF TCWD TO AVOID CONFLICTS OF INTEREST IN APPEARANCE AND IN FACT. IF AN INDIVIDUAL BELIEVES A CONFLICT OF INTEREST EXISTS, IT MUST BE DISCLOSED TO TCWD. IF AN EMPLOYEE, DISCLOSURE SHALL BE MADE TO HIS/HER SUPERVISOR. IF A DIRECTOR, DISCLOSURE SHALL BE MADE TO THE TCWD BOARD OF DIRECTORS. ALL OTHER POTENTIAL CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE CHIEF OPERATING OFFICER. "ENFORCEMENT OF THE POLICY IS BEST STATED BY THE POLICY ITSELF WHICH READS: "IN THE EVENT A LEGAL OR ETHICAL VIOLATION DOES OCCUR, VIOLATORS SHOULD EXPECT DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION, IF AN EMPLOYEE; REMOVAL, SUSPENSION OR RESCISSION, IF A DIRECTOR OR MEMBER; AND FINES, CIVIL AND CRIMINAL PROSECUTION, AND/OR IMPRISONMENT."</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>TCWD BYLAWS ESTABLISH A COMPENSATION COMMITTEE WHICH DETERMINES CEO COMPENSATION. THE COMMITTEE HAS ADOPTED A FORMAL COMPENSATION PHILOSOPHY AND RELIES ON THE RESULTS OF AN ANNUAL CEO PERFORMANCE EVALUATION AS WELL AS AN ANNUAL COMPENSATION ANALYSIS CONDUCTED BY AN OUTSIDE CONSULTANT. THE PRIMARY DATA SET UTILIZED FOR COMPENSATION COMPARISON IS DERIVED FROM OTHER STATE HOSPITAL ASSOCIATIONS THAT ARE SIMILAR IN SIZE AND SCOPE OF OPERATIONS. NO COMMITTEE MEMBERS HAVE CONFLICTS OF INTEREST AS DEFINED IN THIS SECTION. MINUTES ARE MAINTAINED OF ALL COMMITTEE MEETINGS AND THE COMMITTEE REPORTS THE OUTCOME OF THE ANNUAL CEO COMPENSATION REVIEW TO THE FULL BOARD IN THE EXECUTIVE SESSION. TCWD CONTRACTS WITH AN INDEPENDENT CONSULTANT TO PROVIDE COMPARATIVE COMPENSATION DATA FOR ALL OTHER POSITIONS WITHIN THE ASSOCIATION INCLUDING OFFICERS AND KEY EMPLOYEES. THE PRIMARY DATA SET UTILIZED FOR COMPENSATION COMPARISON IS DATA DERIVED FROM OTHER STATE HOSPITAL ASSOCIATIONS. THE ANALYSIS INCLUDES AN ATTEMPT TO MATCH EACH POSITION TO COMPARABLE POSITIONS IN OTHER ASSOCIATIONS AND TO ESTABLISH SALARY GRADES AND MARKET MEDIANS. THIS ANALYSIS ALONG WITH OTHER PERTINENT INFORMATION SUCH AS EVALUATION OF INDIVIDUAL PERFORMANCE, RECOGNITION OF ANY UNIQUE ASPECTS OF A POSITION AND/OR SIGNIFICANT CHANGES IN JOB RESPONSIBILITIES IS USED BY THE CEO AND/OR COO TO GUIDE COMPENSATION DECISIONS WHICH ARE DOCUMENTED AND TRACKED THROUGH TCWD'S HR AND PAYROLL SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TCWD BYLAWS, CODE OF BUSINESS CONDUCT, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TENNESSEE HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
          <CityNm>BRENTWOOD</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37027</ZIPCd>
        </USAddress>
        <EIN>620534232</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(6)</ExemptCodeSectionTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TENNESSEE HOSPITAL EDUCATION &amp; RESE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
          <CityNm>BRENTWOOD</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37027</ZIPCd>
        </USAddress>
        <EIN>620712345</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>THA CENTER FOR INNOVATIVE SOLUTIONS INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5201 VIRGINIA WAY</AddressLine1Txt>
          <CityNm>BRENTWOOD</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37027</ZIPCd>
        </USAddress>
        <EIN>621102328</EIN>
        <PrimaryActivitiesTxt>CONSULTING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TN</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TENNESSEE HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>37384</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>